What the Latest Research Says About Binge Eating Disorder
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Georgie: [00:00:00] This is the breaking up with binge eating podcast, where every listen moves you one step closer to complete food freedom hosted by me, Georgie fear and my team at confident eaters. Welcome back to the Breaking Up With Binge Eating Podcast. I'm Georgie, and today we're talking about a topic that touches more people than most realize. Wait a second. It probably touches everyone in this audience binge Eating disorder or BED, and more importantly, we're diving into what the latest science says about this.

Christina: Binge Eating disorder is the most common eating disorder in North America. More common than anorexia and bulimia combined, and yet it's still widely misunderstood, mischaracterized, and often blamed on willpower or emotional weakness.

Georgie: Believe it or not, they're still doctors that treat this like it's just the same as somebody who has extra weight, and it's certainly not the same.

So to start, binge eating, as we know, is not about a lack of discipline. It's a complex interaction between your brain, your biology, your emotions, and your lived experiences. Today we're gonna explore six of the most important up-to-date research findings that are shedding new light on why BED happens and what can actually help.

Christina: Let's begin with the brain. One of the clearest findings in recent years reinforced by multiple neuroimaging studies from 2023 and 2024, is that individuals with BED have heightened activity in the reward related parts of the brain, like the nucleus accumbens and orbitofrontal cortex when they're exposed to food cues.

So what does that mean? It means that when someone with BED sees a tempting food, [00:02:00] maybe a bag of chips or cookies, their brain doesn't just say, oh, that looks good. It actually lights up in the same way it would for someone who's addicted to a substance. It's an amplified drive toward that reward. What's more, people with BED tend to have reduced connectivity between the prefrontal cortex, which helps with decision making and impulse control, and the limbic system where emotion and rewards are processed.

That means it can be harder to hit the pause button even when part of you doesn't want to binge.

Georgie: That's so fascinating to me. 'cause I think we've all heard people talk about this and felt it ourselves. Like the decision making part of our brain was disconnected from the emotional part and

Christina: Right.

Georgie: So fascinating that there's actually structural differences that can be observed on imaging.

Christina: Yeah.

Georgie: So as we know, this isn't about poor choices or laziness, and in many ways I think professionals who have worked with people in this space have known that for quite a while.

Like, this is not a matter of people, you know, making different choices or having different personalities, that there's very much a medical thing going on. But, research sometimes takes a while to confirm that

Christina: Yeah.

Georgie: it's about how your brain is wired to respond to food, and it's definitely harder for some people to override that signal in the moment. This sort of research findings I think is really helpful because professionals like Christina and Mary Claire and I, we know things like impulse control is a helpful tool to help our clients develop, but now we have more research backing why we do this sort of work. Another area of recent research is medication, specifically GLP one receptor agonists like semaglutide, also known as Ozempic or wegovy and liraglutide. While these medications were originally developed for type two diabetes and obesity, researchers are now exploring their use in other conditions [00:04:00] including binge eating disorder. Early findings from 2023 and 2024 have been very promising. Semaglutide has been shown to reduce binge eating frequency and severity even in people who weren't actively trying to lose weight. There's also been positive research on these same drugs with disorders of addiction or substance use disorders. They've shown that

Christina: Oh wow

Georgie: people who were trying to become abstinent from drugs or alcohol had much more success when they were taking, these GLP one drugs. So I think

Christina: Interesting.

Georgie: yeah, and the FDA still hasn't approved it for these alternate uses, but I would, I'd put money on that being in the, in the pipeline that it'll be approved for other uses too. And.

Christina: Hmm.

Georgie: I think it's exciting 'cause like when you think of the millions of people that are suffering from type two diabetes, obesity, binge eating disorder, and then you add in the millions of people that are suffering from alcohol use disorder and the millions who are suffering from other substance use disorders, like this is so many people.

Christina: Yeah.

Georgie: So it makes sense because if you can alter or improve somebody's reward system to not make them feel so exaggerated of a drive toward that reward and reduce hunger signals. It makes sense. But it is really important to notice that these drugs don't address the emotional or psychological components of binge eating disorder. They can help take the edge off the biological drive, but they're not a replacement for therapy or behavioral change. I think they're one tool in the toolbox, not the whole solution.

Christina: Yeah. And we've seen that too. You've worked with clients who have been on the drug and I have as well, and they have even said that, they're like, I still need other tools, because yes, the food noise is down. Yes, the appetite is down. But now I have nothing to cope with like the stress is still there. The things are still [00:06:00] happening in my life and I have nothing really to work with. So these other tools that we talk about all the time on this podcast are also important Here's a newer, more emerging area of research, systemic inflammation, and the gut brain axis. Some recent studies suggest that people with BED may have elevated levels of inflammatory markers such as C-reactive protein, and differences in their gut microbiome, the bacteria that live in our digestive tract.

Why does that matter? Well, inflammation can affect everything from mood and stress tolerance to how full or hungry you feel, and the gut-brain connection is a two-way street. If the microbiome is out of balance, it can send signals that increase food cravings, impair your mood regulation and blunt satiety cues. Now, this doesn't mean probiotics or an anti-inflammatory diet is like a magic cure for BED, but it does mean the conversation is expanding. We're starting to see BED as not just a mental health issue, but a whole body condition that's influenced by nervous system health, inflammation, and even digestive function.

Georgie: And research on the gut brain connection is moving toward looking at lifestyle factors and the way people live in the real world and how that impacts their gut biome. It's not just about like, oh, which probiotic could we put in a capsule and get, you know, a temporary effect in people, which I think is much more usable in real life because any supplement, to change the gut biome doesn't tend to have a really long-term effect unless you make lifestyle changes that support it. And, you know when I think, wow, my gut biome could potentially be disrupting or supporting my mood. Oh, oh boy does that impact the ease or difficulty of making good food decisions?

Christina: absolutely.

Georgie: So let's shift to some things we've learned in the [00:08:00] treatment side from recent research. Cognitive behavioral therapy or CBT continues to be the most effective and research backed psychological treatment for BED. CBT helps people identify and reframe unhelpful thoughts like I already blew it, so I might as well keep going. It helps people reduce their emotional reactivity, build structured eating patterns, so less prone to skipping meals or eating erratically and strengthens self-efficacy- the belief that you can manage difficult urges or emotions. We sometimes talk, through CBT concepts , to these thoughts as unhelpful thoughts or sabotaging thoughts. So you'll probably hear them if you, if you stick around and listen to more of our episodes.

Christina: Mm-hmm.

Georgie: But here's what's exciting. We've known about CBT for decades and how useful it could be, but in the last few years, digital CBT programs delivered through apps or online platforms have been showing really strong outcomes too, especially when they include check-ins with a therapist or coach. That's important because one of the biggest barriers to treatment for BED is access. Many people don't live near a trained therapist, or they can't afford to sit down with somebody every week for an hour and lay on their couch. Digital CBT and guided self-help models are helping to bridge that gap. That's the approach we use in our breaking up with binge eating group. I love that online delivery for lessons allows people to access and review the material as often as they need, or at 11:00 PM when they're at a party. They can just pull it up on their phone and get a reminder of what they were working on. But because I don't feel like you can ever replace a real human that cares about you, guiding you through the process, every client has a one-on-one video session with a coach every four weeks. So if you are struggling and therapy feels out of reach in the traditional sense, don't give up. There are growing options that can bring support right into your home [00:10:00] on your schedule at a lower cost. So explore some of the digital options

Christina: One of the more fascinating areas of recent research into binge eating disorder has to do with something called interoceptive awareness. That's a fancy way of describing how well we can sense and interpret what's going on inside our bodies. Things that we talk about all the time with our clients, like hunger or fullness, even muscle tension, heart rate, or the physical sensations of emotions.

Georgie: Yeah, it is really interesting how, one of the classic questions that therapists who do, you know, body-based things will ask is like, where do you feel that in your body? It's become the new, like how does it make you feel? It's like the stereotypical therapist question, but it's true.

Like when we feel angry, a lot of times we can tune in and notice that we feel that commonly as like heat in the upper body, in the arms, and. I think I've tuned into that myself, like what is this emotion I'm feeling? And sometimes the cues from my body can help steer me toward identifying what it actually is.

Christina: Mm-hmm.

Georgie: along this same topic of interoceptive awareness is, you know, I've been practicing this stuff for a while, tend to think i'm pretty good at hunger and fullness and all those things, but I realized how terrible I am when I recently was cued by my dentist to try and stop clenching my jaw. And I wear a nice guard at a mouth guard at night, but I've still so very commonly clench my jaw during the day, and the signs of it are obvious.

And so now I'm trying to tune in and. It's so frequent that I haven't been able to improve it as much as I've just gained an appreciation for how frequently I do this without any awareness of it at all. And so it's like, wow. Okay. Interoceptive awareness please expand to include my jaw. Thank you. So back to this research on interoceptive awareness. The recent research is showing people with BED tend to have lower interoceptive awareness than people who don't have BED. In other words, [00:12:00] they're less likely to notice when they're hungry or full and less able to connect emotional cues like anxiety or stress to what they're physically feeling. A 2022 study in appetite used something called the Maya questionnaire. That's the multidimensional assessment of interoceptive awareness and found that individuals with BED scored significantly lower in areas like emotional awareness, self-regulation, and noticing that basically means there's a kind of disconnect between the body and brain. And so while it's good advice for, you know, everybody who crosses our path or comes to us for help, we tend to like to help them develop interoceptive awareness. This subset of our clients who have BED probably just need a bit more time to work with this because it can be more difficult for them than other people.

Christina: And it's not just self-reported data. We're seeing this in brain imaging too. A 2023 FMRI study showed that people with BED had reduced activity in the insular cortex when asked to focus on internal sensations like heartbeat or fullness. From what I understand, the insula is kind of like the brain's dashboard for internal status.

So if it's underactive, it's harder to pick up on the signals your body is trying to send you.

Georgie: And here's the kicker. Those interoceptive deficits actually predict binge eating severity.

Christina: Hmm.

Georgie: A 2024 study in eating and weight disorders found that the less attuned somebody was to their internal state, the more frequent and intense their binge episodes tended to be, even after controlling for stress, depression, and emotional dysregulation.

Christina: That's huge because it tells us this isn't just about mood or willpower. Say it louder for the people in the back.

Georgie: You're right. One more time.

Christina: If your body's hunger and fullness cues feel fuzzy or unreliable, it makes perfect sense that eating becomes more about emotions or habit than actual need.

Georgie: [00:14:00] Exactly, and the good news, interoceptive awareness is something we can train. Mindfulness-based therapies, use body scans, breath awareness, and mindful eating to help people tune back in. DBT, dialectical behavior therapy and some trauma-informed approaches are starting to include interoceptive work too, especially when someone has a history of dissociation or emotional overwhelm.

Christina: And from what I understand, Compassion focused therapy also uses that work like mindfulness and body scans and all of that stuff. So.

Georgie: It's sort of like once it works and we have lots of signs that it works, more people use it.

Christina: Yeah, so if you ever feel like you can't tell when you're hungry or full until it's too late, or like eating is something you do to soothe or numb out, it's not a character flaw. It may be your brain's wiring around internal awareness, and that's something that can change with the right tools. My clients have definitely described that feeling of just being disconnected, not really knowing what things feel like.

So we've seen it in practice as well.

Georgie: For sure. I think this line of research is incredibly hopeful because it gives us a clearer understanding of why binge eating feels so hard to control. And more importantly, it shows that the path to healing doesn't just involve food rules. It's almost like something a caveman practitioner would do to be like, here's your food rules that will cure you from binge eating. We need to help each client reconnect with their body in a way that feels safe and supported.

Christina: One of the most eye-opening findings in recent years is the strong connection found between ADHD and binge eating. People with ADHD are more likely to experience impulsivity, emotional dysregulation, and sensation seeking behaviors. All of which are also common in BED and many people with BED report symptoms of ADHD, even if they've never been formally [00:16:00] diagnosed, which is interesting. This has major treatment implications.

In fact, the only FDA approved medication for BED is

Georgie: you can do it.

Christina: lisdexamfetamine AKA Vyvanse, which is also used to treat ADHD. It's been shown to reduce the number of binge eating episodes and improve control for some individuals. That said, medication isn't right for everyone, and not all binge eating is linked to ADHD, but for people who do have underlying attention or regulation issues, identifying that link can be a huge breakthrough.

Georgie: It is important to note that treating ADHD with medications has implications for binge eating disorder because many of the medications used can affect appetite.

Christina: Mm-hmm.

Georgie: with a few people who have both of these diagnoses and if we don't plan how their daytime meals are going to look. It's really common for people who are taking an ADHD medication to have no appetite for breakfast or lunch and then be overcome by powerful hunger in the late afternoon or dinner time. So with smart planning, we can prevent that sort of medication induced hunger roller coaster. 'cause otherwise it can just lead to a binge every night.

Christina: Exactly. So what does all this mean? It means that binge eating disorder is not about being bad at dieting or lacking motivation. It's a condition with deep roots in brain chemistry, emotional coping, physiology, and life experience. It also means that treatment is not one size fits all. For some people, therapy or nutrition counseling is key.

For others, medication helps to turn the volume down. For many, it's a combination plus nervous system support, plus gut health, plus self-compassion. So if you struggle with binge eating, please know you're not alone and you're not broken. [00:18:00] There is real science behind what you're experiencing, and there are more tools available now than ever before to help you heal.

You can recover, you can build trust with your body. And you can learn new ways to meet your needs without shame, punishment, or all or nothing thinking.

Georgie: If this episode resonated with you, or if you've been feeling stuck in cycles of binge eating, we'd love to support you. Our coaching programs are designed for real life. We combine structure with compassion, and we help you understand your patterns from the inside out, not just from a diet lens. Check the show notes for a link to learn more and know that wherever you are in your journey, you deserve support. Thanks for being with us today. We'll see you next time.